Dermatoses induced by Personal Protective Equipment
PPE use can cause skin lesions from friction and moisture.
Dermatoses induced by Personal Protective Equipment are skin lesions that occur due to the use of personal protective equipment (PPE). Such equipment, including masks, face shields, goggles, gloves, and gowns, can cause abrasion and retain moisture on the skin, particularly the face. During the COVID-19 pandemic, healthcare workers and the general public needed to use PPE for extended durations, leading to skin problems from friction, pressure, long-term sealing, and moisture retention.
- prevalence_in_study
- 97% of frontline health workers had some skin damage
- common_symptoms
- tenderness (70%), itching (57%), burning pain (38%)
- highest_risk_equipment
- goggles, N95 masks, hand hygiene measures
- lowest_risk_equipment
- gloves and face shield
- common_sites
- nasal bridge, cheek, hands, forehead
Lore & Background
A Chinese study reported that 97% of frontline health workers experienced some form of skin damage from PPE. Those who wore PPE for more than six hours had higher risks of skin damage than those who wore it for less time. Goggles, N95 masks, and hand hygiene measures had the highest odds of causing skin damage, while gloves and face shields had the least. Commonly reported symptoms included tenderness (70%), itching (57%), and burning pain (38%). Skin lesions observed included erythema, maceration, fissure, papule, erosion, ulceration, vesicle formation, and wheal formation. The most prone sites were the nasal bridge, cheek, hands, and forehead.
Reader's Guide
The significance of dermatoses induced by Personal Protective Equipment lies in their high prevalence among frontline health workers during the COVID-19 pandemic, with a Chinese study finding that 97% experienced some skin damage. Extended wear of PPE, especially for over six hours, increased risk. Goggles, N95 masks, and hand hygiene measures were the most damaging, while gloves and face shields were least. Common symptoms included tenderness, itching, and burning pain. Lesions ranged from erythema to ulceration. Prevention is critical to avoid PPE protocol breaches from inadvertent adjustment. Recommendations include testing N95 masks for fit, keeping facial skin clean and moisturized, and applying moisturizer at least one hour before donning masks. For contact dermatitis, switching glove materials and using topical corticosteroids or oral cortisone for severe cases is advised. The impact includes potential mental health effects from facial dermatoses.
Did You Know?
- A Chinese study reported that 97% of frontline health workers had some kind of skin damage from PPE.
- Healthcare workers who wore PPE for more than 6 hours had higher risks of skin damage than those who wore it for less time.
- Goggles, N95 masks, and hand hygiene measures had the maximum odds for inflicting skin damage, while gloves and face shields had the least.
- The American Academy of Dermatology recommends applying moisturizer at least one hour before donning N95 masks and skipping makeup such as foundation and concealers.
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